Equipment for the management of hospital activities such as pharmaceutical treatment

ABSTRACT

An equipment for the management of hospital activities as medical tests and pharmacological treatment in conditions of certainty against the mistaking of patients is described. The equipment comprises a bed unit ( 1 ) associated with the bed of each patient, at least one cabinet unit ( 2 ) associated with every ward and a computerised tray cart ( 3 ) that is movable among said units ( 1, 2 ). The computerised tray cart ( 3 ) comprises a computer ( 10 ) provided with display, a reader ( 11 ) of computer data connect with said computer ( 10 ) and approachable to the bed of the patient for the reading of computer data and their transfer to said computer ( 10 ), a plurality of drawers ( 14-16 ) with opening controlled by said computer ( 10 ), and a printer ( 17 )controlled ( 10 ). The bed unit ( 1 ) comprises a display ( 18 ) connected with a computer for the visualisation of data relative to the patient. The cabinet unit ( 2 ) comprises a computer ( 22 ), a reader ( 23 ) of computer data connected with said computer ( 23 ), containing spaces and drawers ( 24-27 ) with opening controlled by said computer ( 22 ). The computerised tray cart ( 3 ), the bed unit ( 1 ) and the cabinet unit ( 2 ) are connected to each other by a computer network.

This is a nationalization of PCT/EP 01/06463, filed Jun. 7, 2001 andpublished in English.

DESCRIPTION

The present invention concerns an equipment for the management ofhospital activities as laboratory tests, pharmacological treatment,dieting and instruments diagnostic that is operating in conditions ofcertainty against the mistaking of patients and/or of the productsdestined to it.

One of the greatest risks for patients staying in a hospital or otherhealth care institute consists in the possibility that the data relativeto the tests and to the dispensing of drugs are mistaken by errorbetween one patient and the other or that they are not objectivelyinterpreted. Therefore, a different disease that is consequently treatedin different way can be diagnosed to a patient affected by a certaindisease or, even in the presence of an exact diagnosis, drugs that aresuitable for a different disease can be given to him/her.

This problem has been faced in its most general aspects by Europeanpatents n. 0491900 and n. 0516782, the first one being specificallyaddressed to blood tests or other biological samplings, the second beingaddressed to the dispensing of drugs, the latter term meaning also thedispensing of blood plasma.

Both patents provide for the use of a computer data support that isapplied to the patient in such a way that it cannot be removed until theend of hospitalisation, in substance a wrist-band that is fastened tothe wrist of the patient. The computer data which are read on thewrist-band with appropriate optical reader allow, in the case ofcollection and testing of biological samples, to then mark the containerof the collected biological sample in a substantially permanent way withthe same data, which therefore accompany the same container until thetesting laboratory, thus avoiding the mistaking of samples between onepatient and the other. In the case of dispensing of drugs the reading ofthe computer data on the wrist-band, in combination with the reading ofadditional computer data on a drug container or on the same drug, allowsin turn to give the drug that was prescribed for that given patient withabsolute certainty.

In European patent n. 0516782 there is also described in general termsthe use of a tray cart provided with computer means for the reading,processing and confirm, that can be moved from the patient to the sitewhere the drugs are being dispensed and vice-versa in order to assurethe perfect correspondence between the prescribed therapy and the drugbeing taken.

In the same European patent a possible implementation of a machine isdescribed that is capable to feed, to mark and to fill up with drugs andfinally to close drug containers, once again by using computer datacorresponding to the ones being read on the wrist-band of the patient.

Nothing is provided instead at the patient's bed, but the presence of awrist-band that is fastened to the wrist of the same patient.

Scope of the present invention is now to provide an equipment that, byusing the teachings provided by the two aforesaid European patents,allows to manage in a complete way the hospital activities of medicaltests and pharmacological treatment (extending such concept to dieting)while preventing errors due to the mistaking of patients.

According to the invention such scope is attained with an equipmentcomprising a computer data support that is fastened to every patient ina substantially permanent way, a bed unit associated with the bed ofevery patient, at least one cabinet unit associated with each ward and acomputerised tray cart that is movable among said units, characterisedin that:

a) said computerised tray cart comprises a computer provided withdisplay and mouse control for the processing of computer data, a readerof computer data connected with said computer and movable near the bedof the patient for the reading of computer data and their transfer tosaid computer, a plurality of drawers with opening controlled by saidcomputer for the housing of containers for biological samples to becollected and of drug containers to be dispensed, a printer controlledby said computer for the printing of labels with computer datacorresponding to the ones being read by said reader which are destinedto said biological samples containers, and sensors of the patient'svital parameters communicating with said computer;

b) said reading unit comprises a display that is connected with acomputer for the visualisation of data relative to the patient, sensorsfor the detection of data relative to the patient (for instance:presence);

c) said cabinet unit comprises a computer, a computer data readerconnected with said computer, spaces and containing drawers with openingcontrolled by said computer;

d) said computerised tray cart, said bed unit and said cabinet unit areconnected with each other by a computer network.

The equipment according to the invention, which is obviously integrablewith specific devices and instruments that are considered as being moreappropriate each time, allows a safe management of all hospitalactivities as medical tests and pharmacological treatment and dieting,while eliminating any possibility of error due to the mistaking ofpatient (including not correct relationing of objective data regardingthe patient) from the origin. All data are in fact taken, transmitted,verified and compared via computer without the operator being able toinfluence the exactness or less of the operation.

The characteristics of the present invention will become evident fromthe following detailed description of an embodiment thereof, that isillustrated as a non limiting example in the enclosed drawings in which:

FIG. 1 shows the schematic general assembly of an equipment according tothe invention;

FIG. 2 shows the same equipment completed with a central unit for thesupply of drugs;

FIG. 3 shows an example of computerised tray cart utilisable in theequipment according to the invention;

FIG. 4 shows an example of bed unit for the equipment according to theinvention;

FIG. 5 shows an example of wrist-band for the support of computer datafastenable to the patient;

FIG. 6 shows an example of cabinet unit for the equipment according tothe invention.

As schematically shown in FIG. 1, the equipment according to theinvention substantially comprises a bed unit 1 for each patienthospitalised in health care institute, at least one cabinet unit 2 forevery ward of the health care institute and a computerised tray cart 3that is movable from one unit to the other. In addition, for eachpatient, a computer data support permanently associable with the patientis provided, preferably a wrist-band 4 with computer data 5 as shown inFIG. 5.

If the equipment is utilised for the dispensing of drugs, the healthcare institute can provide for a central unit 6 suitable to supply withdrugs several equipments of the ward, as shown in FIG. 2.

The computerised tray cart 3, more clearly illustrated in FIG. 3, ismade up of a frame 7 resting on wheels 8, on which a revolving arm 9 canrotate for the support of a portable personal computer 10 with displayand mouse control and of an optical reader 11 connected with saidcomputer and provided with wire extension (or other wireless device) inorder to allow its movement near the bed of the patient for the readingof the computer data that are memorised on the wrist-band 4 and theirtransfer to the computer 10.

On the top plane of the frame 7 there is also arranged a revolving arm12, which supports a device 13, controlled by the computer 10, for themonitoring of the vital parameters of the patient. The device 13 iscomposed of an additional display and of sensors of the patient's vitalparameters such as arterial pressure, oxygen saturation, heart frequencyand temperature. The mains power supply is done by means of a easilyremovable multipolar connector and connected with a supply box. The sameis true for the connection with the data network, which can also beobtained through wireless communication.

The body of the frame 7 provides a set of drawers on the frontconsisting in three rows of drawers 14, 15 and 16, part of which havingopening controlled by the computer 10 through actuators and/orindicators and/or sensors; other drawers of the same typology can bepresent inside other spaces of the tray cart. On one side of the frame 7a printer 17 for labels is instead provided. Additional components ofthe tray cart 3, such as containers of clinical charts, containers forsyringes and storage spaces of various type, also are provided but notdescribed because of minor interest to the purpose of the inventionherein claimed.

The bed unit 1, better illustrated in FIG. 4, comprises a display 18fastened to the foot of the hospitalisation bed 19 and connected viacable or by radio frequency to a computer (not shown) for thevisualisation of data relative the patient. In addition sensors (notshown) connected with remote stations are provided in order to detectthe presence or less of the patient on the bed. A bedside table 20 canbe provided with drawers 21 with traditional opening or controlled bycomputer according to the same typologies already described for the traycart.

The cabinet unit 2, at least one for unit, better shown in FIG. 6,comprises a portable personal computer 22, an optical reader 23connected with the computer 22, a space with single door 24 and threegroups of drawers 25-27 with traditional opening or controlled by thecomputer 22 according to the same typologies already provided for thetray cart. There is also provided, even if not shown, a refrigeratorunit for the cooling of the space 24 and of the drawers 25-27.

Finally, the computerised tray cart 3, the bed unit 1 and the cabinetunit 2 are connected to each other, and possibly to the central unit 6for the supply of drugs, by a computer network.

In the sphere of medical testing the equipment according to theinvention is utilised as follows. The tray cart 3 is moved near the bedof the patient and the optical reader 11 is pointed onto the wrist-bandapplied to the patient in order to read the computer data(administrative and/or clinical data, etc.) that are memorised on thesame; the reading is communicated to the computer 10. The operator incharge takes one or more containers of biological samples, for instancea test-tube, from one of the drawers of the tray cart that are notnecessarily subject to controlled opening and submits the markingpresent on every container, for instance a label, to reading so as toallow to verify by computer 10 if the container is appropriate for typeand characteristics (for instance: product code, batch, expiration).Such reading can possibly be avoided on the basis of preciseconfiguration rules of the software procedures. If the verificationgives positive result, the computer 10 enables to operation the printer17, that prints, and possibly directly applies on each container a labelwith the patient's data that had previously been read by the reader 11.Then the collection of the biological sample of the patient and itsinput into the labeled container or containers, that are finally closedand sealed. The previously described modality for the identification andupdating of the marker, for instance the printing and application of thelabel being produced, can be carried out automatically by an appropriatedevice to which the containers can be fed automatically or manuallythrough a storage of containers.

As an alternative to the above described operating modality, definableas single collection modality, a multiple collection modality can beprovided, according to which as many groups of containers as there arepatients to be submitted to laboratory testing are prepared, eachcontainer of a group is provided with label with the data of therelative patient, etc, and inserted in a sealable casing (for instanceone of the controlled opening drawers or other container in turnlabelled or otherwise marked with the data of that patient, etc). Thetray cart is then brought in proximity of the bed of the first patient,where the reading of the relative wrist-band and of the label is carriedout or other marking in case of the use the containers' casing and, ifthe comparison of the two readings is positive, theactuator/sensor/indicator relative to the opening of the drawer iscontrolled or else the opening of the casing marked with the same datais authorised for the access to the container to which the collection isdestined.

The filled containers, possibly included in envelopes that are sealableby a label issued with the data associated with the activity just beingcarried out and the remaining ones, are then inserted into a drawer ofthe tray cart and transferred to the laboratory, where the conveyedinformation will be duly read through the product labels. If instead theequipment according to the invention is used for the dispensing ofdrugs, the way it operates is the following.

With the tray cart 3 close to the bed of the patient, the operator incharge through the reader 11 carries out the reading of the computerdata of the patient and eventually those of an appropriate labelfastened to the print clinical chart of the patient, while verifying thecorrespondence of the personal identification data. The data relative tothe therapy to be followed and therefore to the drugs to be dispensedare therefore communicated through the computer 11, which applies thecongruence rules of the pre-set activities and signals to the operatorinvolved the possible not conformity alarms. Such data are generallycommunicated, according to set rules, to all computers connected by thecomputer network and to the respective operators.

The tray cart is then carried near the cabinet unit of the ward, wherethe opening of the drawer of the cabinet that contains the drug to bedistributed and the one of a drawer of the tray cart is carried outthrough computer. The drug is then transferred from a drawer to theother and the two drawers are then closed again. As an alternative, thedrug can be introduced in a container sealed by a label with the data ofthe dispensing (for instance, patient, time, etc.) that is produced bythe printer connected with the computer.

The tray cart is then brought back near the bed of the patient, wherethe reading of the wrist-band of the same patient is carried out and, incase of congruity with the data that are memorised in the computer, theactuator/alert/sensor relative to the opening of the drawer containingthe drug to be dispensed is controlled. As an alternative, the readingof the wrist-band of the patient, in conjunction with the reading of thelabel placed on the sealed container, activates the computer to emit tothe operator the authorization for the operation of opening anddispensing to the patient.

The modality just described regarding the drug can also be consideredvalid for the distribution of meals.

If desired, the same drug can momentarily be inserted in one of thedrawers associated with the bedside table near the bed to be then givento the patient at the proper time, still under control given by thecomputer.

The flow of the drugs from the central unit or central pharmacy 6 to thesingle cabinets of the ward is finally regulated as follows. Thedatabase of the central pharmacy is updated in real time and itcommunicates with the cabinets of the ward. The drugs are distributed bythe central pharmacy to the cabinets of the ward. The informationregarding charge and discharge of the cabinets are updated in thedatabase of the pharmacy and in the computers of the cabinets.

What is claimed is:
 1. Equipment for the management of hospitalactivities of medical tests and pharmacological treatment in conditionsof certainty against the mistaking of patients, comprising a support (4)for computer data (5) that is attached to each patient in asubstantially permanent way, a bed unit (1) associated with the bed ofeach patient, at least one cabinet unit (2) associated with every wardand a computerised tray cart (3) that is movable between said units (1,2), characterised in that: a) said computerised tray cart (3) comprisesa computer (10) provided with display and mouse control for theprocessing of computer data, a reader (11) of computer data connectedwith said computer (10) and approachable to the bed of the patient forthe reading of computer data and their transfer to said computer (10), aplurality of drawers (14-16) with opening controlled by said computer(10) for the housing of containers of biological samples to be collectedand of drug containers to be dispensed, a printer (17) controlled bysaid computer (10) for the printing of labels with computer datacorresponding to the ones being read by said reader (11) which aredestined to said containers of biological samples, and sensors (13) ofphysiopathological parameters of the patient communicating with saidcomputer (10), one or more batteries for the supply of the activedevices, possibly an electric motor for the movement of the tray cart, adevice for the electrical/data connection on board and a device for theelectrical/data connection on the ground; b) said bed unit (1) comprisesa display (18) and sensors/actuators/indicators connected with acomputer for the visualisation of data relative to the patient; c) saidcabinet unit (2) comprises a computer (22), a reader (23) of computerdata connected with said computer (23), containing spaces and drawers(24-27) with opening controlled by said computer (22); d) saidcomputerised tray cart (3), said bed unit (1) and said cabinet unit (2)are connected to each other by a computer network.
 2. Equipmentaccording to claim 1, characterised in that said bed unit (1) comprisesin addition sensors of the presence of the patient.
 3. Equipmentaccording to claim 1, characterised in that said bed unit (1) comprisesin addition a bedside table provided with drawers (21) with openingcontrolled by means of computer.